How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $338.84 Median $2,951.21 Typical High $10,964.78 | Facility | None | $338.84 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $380.19 | Professional | None | $138.04 | $257.04 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $323.59 | Professional | None | $199.53 | $199.53 | $323.59 |
AvMed Setting Facility Modifier None Typical Low $316.23 Median $6,025.60 Typical High $13,182.57 | Facility | None | $316.23 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $151.36 Median $302.00 Typical High $380.19 | Professional | None | $151.36 | $302.00 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $257.04 Typical High $562.34 | Professional | None | $114.82 | $257.04 | $562.34 |
Florida Blue Setting Facility Modifier None Typical Low $58.88 Median $371.54 Typical High $371.54 | Facility | None | $58.88 | $371.54 | $371.54 |
Florida Blue Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $436.52 | Professional | None | $245.47 | $316.23 | $436.52 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $741.31 | Professional | None | $213.80 | $295.12 | $741.31 |
United Setting Facility Modifier None Typical Low $169.82 Median $1,819.70 Typical High $5,248.07 | Facility | None | $169.82 | $1,819.70 | $5,248.07 |
United Setting Professional Modifier None Typical Low $138.04 Median $281.84 Typical High $562.34 | Professional | None | $138.04 | $281.84 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $269.15 Typical High $269.15 | Professional | None | $112.20 | $269.15 | $269.15 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $125.89 Typical High $186.21 | Professional | 52 · Reduced service | $69.18 | $125.89 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $51.29 Typical High $74.13 | Professional | 53 · Discontinued | $28.18 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $190.55 Typical High $275.42 | Professional | 54 · Surgery only | $104.71 | $190.55 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $38.02 Typical High $54.95 | Professional | 55 · Aftercare only | $20.89 | $38.02 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $25.70 Typical High $37.15 | Professional | 56 · Pre-op care only | $13.80 | $25.70 | $37.15 |
Where Florida sits
The same service costs 3.3 times more in Alaska than in Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Florida· 47th of 51
$275
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.